Just a few things....

I am two months post-op, and I've got a few questions: 

1)  Constipation:  It's like passing bricks.  I have tried using a couple Colace per day and they didn't soften things up.  I've started drinking half a cup of prune juice each morning, which seems to work much better, but it has loads of carbs and I hate having to use my allocation that way.  I've been reading posts on here about horrid gas and stool smells.  I have not had any of that.  With the juice, it smells normal and my stool is softer.  Should I be on probiotics?

2)  Appetite:  Still none.  After taking a couple bites of food, I don't want to eat more.  I am now able to eat pretty much anything but I am forcing myself to get about 60 grams of protein, plus drink as much fluid as I can.  I do focus on protein before eating anything else, and it does help being able to eat more than just the protein.   I've read that around the four month mark, appetite starts coming back.  I welcome that event.  I am able to eat non-protein items (Triscuits, veggies) better, but I know I have to put protein in my stomach first and foremost.  I have not had sweets or sugar yet.  Can we eat hard candies, or will they mess me up?

3) Fats:  Are we to eat full fat items - mayo, cheese, butter, etc?  Or at 2 months, should I still be a little more careful and eating low fat?

I'm still concerned about the hair falling out possibility at some point.  I've read people do that -- does everyone?

Thanks for any answers you all can provide.  I love watching the scale go down, even if it's only about 2 pounds a week.  It sure beats gaining each week!

Nancy

Hi Nancy!

Constipation sucks!  I have found that calcium is the main culprit, however, I also take narcotics for chronic pain, which just makes things worse. I tried everything short of enemas: colace, dulcolax, miralax, benefiber.  Nothing.  As per the wise vets on here and proboards, I have added magnesium to each dose of calcium, and it works wonders!  Like clockwork.  It was suggested to use a 2:1 ratio for dosing, so I take 500mg calcium/250mg mg citrate.  I haven't tried any probiotics, but I do eat a Greek yogurt every day.  I haven't noticed that my gas/poop smell is outrageously horrendous, mostly just different, with a longer hang time.  I am only 4 1/2 months out, so I know as my diet increases and changes, this might, too.

Appetite:  You will see people here refer to big tummy days and small tummy days.  My appetite is sloooooooowly returning, but it remains frustrating that I get so full after 3-4 bites.

Fats:  My NUT specifically told me low fat everything, the vets say full fat, since we only absorb 20(?)% of what we take in.  I do full fat.

I'm still concerned about the hair falling out possibility at some point.  I was told to expect this at about 3 months.  Fingers crossed- I have def noticed more strands dropping, but this could just be me being paranoid.  No clumps or handfuls.  I have also added 10000mcg of Biotin to my supplements at the suggestion of my hairdresser.

Congrats on your success so far!

Hi there. Here is my perspective at 5 months.

How are you doing on fluids? Maybe try and up those for the constipation. I went from
64 to 90 or more and it helped me. I've seen some people using quarter or half doses of
Miralax too.  Active culture yogurt if you go to far in the other direction.

The first 3 or 4 months I had to eat on a schedule or I wouldn't get the protein in. I wasn't hungry
and not really interested in eating. Some appetite came back after 3 months and I now have an
occasional day where I can be hungry all day. I still mostly stick to protein and a small amount of
vegetables. I do crackers with cream cheese as an evening snack so carbs are
kept fairly low.

At two months I think you are OK to handle the full fat items. I would just ease back into them one at a time
to give your stomach some chance to adjust.

Probiotics - I have some smelly stools. Usually the active cultures in yogurt are enough for me. Once you are
past the constipation you may see more need for them. Everyone is different. The worst I have seen is that 
some people have a hard time starting and others see no difference. Everyone is different. Always something
to keep an open mind about - lots of interesting research going on about "intestinal flora".

My hair thinned. I've tried biotin for the past month and see no real difference. Again, one of those things where
everone is different. Certainly not a foregone conclusion so it may not happen to you.

Glad to hear you are doing well (except for the constipation - I hate when that happens).

Oh, and the sugars in candy, even sugar free candy may mess you up especially this early out.

1) Increasing the fats and oils might help with constipation. Also, I had to switch from Citracal to Vitalady's calcium citrate only capsules. The fillers in Citracal were brick-makers. 

2) The appetite will start coming back, hang tough. I still use a lot of protein shakes because I have a lot of restriction. I still would not be able to get 120 grams of protein via food and I'm not so sure we can properly break food down to get all that much protein from it anyway. I know folks who were able to eat 120 grams of protein and still became protein malnourished. They had to go back to 6 protein shakes a day to recover. I'm not sure how many they still drink at 6 years post-op.

3) Eat full fat within reason and it should help with the constipation. 

Just about everyone I've ever read about loses some hair. Our dietitian says it's a combo of hormone dumping, ketosis and the anesthesia used at the time of surgery.

Keep up the good work!

--gina

#1 (calcium-wise) may be my issue! I started taking my full dose of Citracal and now I feel like I'm passing bricks. Thanks for the info.

So calcium is the culprit........ and I take it all day long!  But I do have the mag. citrate and will work on increasing protein and fats, gradually.  At this point, are protein bars permitted, or should we still be getting it by other protein foods or shakes?  Also, how soon after surgery did you all start drinking carbonated beverages?  And one more question, I cannot tolerate the taste or smell of decaf coffee.   Is it permissible to go back to caffeinated coffee?  I really appreciate the feedback.  This forum is wonderful!

1) For the constipation, as much fluids and fats as you can stand.

2) All doctors are different in how quickly you can progress in foods, but my major issue with protein bars was the sugar alcohol content. Try one (or a part of one) and see how you react to it. Sugar alcohols give me major headaches-- I do way better with real sugar.

3) I never stopped drinking real caffeinated coffee, and by your point I was definitely drinking my protein in my coffee. I crave it now!

4) I had my first taste of diet coke at about a month out. At first, I could only drink a part of one because I got so full. Some people have trouble with carbonation, but I never have. Now (3 years out) I drink one diet coke per day.

So...to recap-- everybody's different. ;) I can't do sugar alcohols or drink with my meals-- but I have no trouble with carbonation. You just have to try things one at a time and see how you personally react.

Good luck!

Each person is different.

1) Constipation...my bet is the calcium and not enough fluid and fat. While the prune juice may help (it's a fluid), so would just adding more water. Make sure you are getting in at least 64 oz a day. Probiotics are also a good idea. at this point.

2) Appetite: As long as you get in your fluids and about 60 grams of protein this month, you will be okay. 30/60/90+ rule for protein...30 grams by 30 days, 60 grams by 60 days, and 90+ grams by 90 days. Anything with sugar alcohols will be a gas maker. Having an OCCASIONAL hard candy...like maybe one or two a month, no big deal. Stay away from Triscuits...use celery or a spoon as a "triscuit".

3) Fats: Do NOT eat low fat but still be careful as to how much you consume right now...it's a fine balance between not getting enough (constipation) and getting too much (oil slicks). And consider this: in order to make low fat items taste good, they have to add something, usually SUGAR.

4) Hair: mine thinned at about month 4...and that lasted til I hit about the 12 month mark. (I had my gallbladder out at month 6 that set me back on that). So I got my hair cut much shorter than I had ever worn it...and love the freedom. Some try biotin and other methods...but the condition is normal...your hair is always cycling between what is falling out and what is new. Just make sure your protein, fats, and vitamins are good and what is new will be healthy. Can't stop the dead hair from falling out. All biotin did for ME was grown my chin hair which does NOT need help. :)

Liz